tbuckley/cabot-search huggingface dataset:
The Effect of Moderate Alcohol Intake on Serum Apolipoproteins A-I and A-II
Authors: Carlos A. Camargo
Journal: JAMA (1985)

High serum concentrations of apolipoprotein (apo) A-I are associated with a decreased risk of coronary heart disease. To study the effect of alcohol intake on serum apo A-I and A-II concentrations, 24 healthy male drinkers (37.8 ±13.9 mL [1.3 ±0.5 oz] of ethanol per day, mean±SD) were randomized into treatment and control groups after a three-week baseline period. The treatment group abstained from all intake of alcohol for the six weeks following randomization and then reverted to its usual level of intake for a five-week period. The control group continued its usual level of drinking throughout the trial. The concentrations of apo A-I and apo A-II of abstainers decreased significantly compared with the corresponding changes in controls. After drinking was resumed, apo A-I and apo A-II concentrations were significantly increased in the treatment group compared with the corresponding changes in the control group. These results suggest that the association between moderate alcohol intake and reduced risk of coronary heart disease may be mediated in part by increased levels of serum apo A-I or apo A-II, or both. (<i>JAMA</i>1985;253:2854-2857)
Combination GnRH antagonists for endometriosis: Balancing efficacy with side effects
Authors: L.H.R. Whitaker, L. Saraswat, A.W. Horne
Journal: Cell Reports Medicine (2022)

Endometriosis is a chronic pain condition affecting 1 in 10 women. There is an unmet need for better medical treatments for endometriosis. We spotlight trials of a single preparation combined HRT-GnRH antagonist (Relugolix) by Giudice et al.,
A novel technique using a multiloop traction device for colonic diverticular bleeding
Authors: Yutaka Okagawa, Ryoji Fujii, Tetsuya Sumiyoshi, Mai Fukuda, Yusuke Tomita, Takeyoshi Minagawa, Hitoshi Kondo
Journal: Endoscopy (2022)

Colorectal endoscopic procedures can be technically difficult in cases of poor endoscopic operability [1] [2]. Recently, the usefulness of traction devices in gastrointestinal endoscopic submucosal dissection has been demonstrated, and there have been several reports on their application in other endoscopic procedures [3] [4]. Herein, we report a case of successful endoscopic hemostasis using a traction device for colonic diverticular bleeding with poor scope operability.
Endoscopic submucosal dissection of squamous cell carcinoma accompanied by adenoid cystic carcinoma of the esophagus
Authors: Qian Aihua, Zhang Benyan, Li Weiguang, Sun Yunwei
Journal: Endoscopy (2022)

Adenoid cystic carcinoma of the esophagus is a rare tumor and difficult to detect early [1] [2]. Esophageal squamous cell carcinoma (ESCC) has a characteristic magnifying endoscopic appearance [3]. However, adenoid cystic carcinoma of the esophagus can have atypical endoscopic features.
Evaluation of Nonpharmacologic Interventions and Sleep Outcomes in Hospitalized Medical and Surgical Patients
Authors: Eva S. van den Ende, Hanneke Merten, Lisanne Van der Roest, Belle Toussaint, Quirine van Rijn, Marjolein Keesenberg, Anne M. Lodders, Kim van Veldhuizen, Iris E. Vos, Sophie Hoekstra, Prabath W. B. Nanayakkara
Journal: JAMA Network Open (2022)

Inadequate sleep negatively affects patients' physical health, mental well-being, and recovery. Nonpharmacologic interventions are recommended as first-choice treatment. However, studies evaluating the interventions are often of poor quality and show equivocal results.To assess whether the implementation of nonpharmacologic interventions is associated with improved inpatient night sleep.In a nonrandomized controlled trial, patients were recruited on the acute medical unit and medical and surgical wards of a Dutch academic hospital. All adults who spent exactly 1 full night in the hospital were recruited between September 1, 2019, and May 31, 2020 (control group), received usual care. Patients recruited between September 1, 2020, and May 31, 2021, served as the intervention group. The intervention group received earplugs, an eye mask, and aromatherapy. Nurses received sleep-hygiene training, and in the acute medical unit, the morning medication and vital sign measurement rounds were postponed from the night shift to the day shift. All interventions were developed in collaboration with patients, nurses, and physicians.Sleep was measured using actigraphy and the Dutch-Flemish Patient-Reported Outcomes Measurement Information System sleep disturbance item bank. Other outcomes included patient-reported sleep disturbing factors and the use of sleep-enhancing tools.A total of 374 patients were included (222 control, 152 intervention; median age, 65 [IQR, 52-74] years). Of these, 331 were included in the analysis (195 [59%] men). Most patients (138 [77%] control, 127 [84%] intervention) were in the acute medical unit. The total sleep time was 40 minutes longer in the intervention group (control: median, 6 hours and 5 minutes [IQR, 4 hours and 55 minutes to 7 hours and 4 minutes]; intervention: 6 hours and 45 minutes [IQR, 5 hours and 47 minutes to 7 hours and 39 minutes]; P < .001). This was mainly due to a 30-minute delay in final wake time (median clock-time: control, 6:30 am [IQR, 6:00 am to 7:22 am]; intervention, 7:00 am [IQR, 6:30-7:30 am]; P < .001). Sleep quality did not differ significantly between groups. For both groups, the main sleep-disturbing factors were noises, pain, toilet visits, and being awakened by hospital staff. Sleep masks (23 of 147 [16%]) and earplugs (17 of 147 [12%]) were used most. Nightly vital sign checks decreased significantly (control: 54%; intervention: 11%; P < .001).The findings of this study suggest that sleep of hospitalized patients may be significantly improved with nonpharmacologic interventions. Postponement of morning vital sign checks and medication administration rounds from the night to the day shift may be a useful way to achieve this.Netherlands Trial Registry Identifier: NL7995.
Association of SARS-CoV-2 Infection With New-Onset Type 1 Diabetes Among Pediatric Patients From 2020 to 2021
Authors: Ellen K. Kendall, Veronica R. Olaker, David C. Kaelber, Rong Xu, Pamela B. Davis
Journal: JAMA Network Open (2022)

This cohort study assesses the association of COVID-19 with new-onset type 1 diabetes among pediatric patients.
Representation of Asian American Populations in Medical School Curricula
Authors: Peter Sang Uk Park, Eda Algur, Sweta Narayan, William B. Song, Matthew D. Kearney, Jaya Aysola
Journal: JAMA Network Open (2022)

Despite being one of the fastest-growing populations in the US, the Asian American population is often misrepresented in and omitted from health research and policy debate. There is a current lack of understanding of how Asian American populations are portrayed in medical school curricula.
Management of front line chronic lymphocytic leukemia
Authors: Nadine Kutsch, Anna Maria Fink, Kirsten Fischer
Journal: American Journal of Hematology (2022)

Abstract Treatment options with targeted agents have changed the treatment landscape of CLL profoundly. Besides chemoimmunotherapy, treatment regimen approved for frontline therapy include continuous treatment with BTK inhibitors like ibrutinib and acalabrutinib or fixed‐duration regimen like venetoclax‐obinutuzumab with the approval of venetoclax‐ibrutinib to be awaited. Although these agents have usually manageable side effects, toxicities might limit choices for the individual patient. We here discuss latest trial data and propose a treatment algorithm for frontline treatment of CLL according to fitness and relevant genetic risk factors like IGHV mutational status and TP53 aberrations.
Two Cases of Monkeypox-Associated Encephalomyelitis — Colorado and the District of Columbia, July–August 2022
Authors: Daniel M. Pastula, Matthew J. Copeland, Markus C. Hannan, Samuel Rapaka, Takashi Kitani, Elizabeth Kleiner, Adrienne Showler, Cindy Yuen, Elizabeth M. Ferriman, Jennifer House, Shannon O’Brien, Alexis Burakoff, Bhavik Gupta, Kelli M. Money, Elizabeth Matthews, J. David Beckham, Lakshmi Chauhan, Amanda L. Piquet, Rebecca N. Kumar, Carlo S. Tornatore, Kia Padgett, Kevin O’Laughlin, Anil T. Mangla, Princy N. Kumar, Kenneth L. Tyler, Siobhán M. O’Connor
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

Monkeypox virus (MPXV) is an orthopoxvirus in the Poxviridae family. The current multinational monkeypox outbreak has now spread to 96 countries that have not historically reported monkeypox, with most cases occurring among gay, bisexual, and other men who have sex with men (1,2). The first monkeypox case in the United States associated with this outbreak was identified in May 2022 in Massachusetts (1); monkeypox has now been reported in all 50 states, the District of Columbia (DC), and one U.S. territory. MPXV is transmitted by close contact with infected persons or animals; infection results in a febrile illness followed by a diffuse vesiculopustular rash and lymphadenopathy. However, illness in the MPXV current Clade II outbreak has differed: the febrile prodrome is frequently absent or mild, and the rash often involves genital, anal, or oral regions (3,4). Although neuroinvasive disease has been previously reported with MPXV infection (5,6), it appears to be rare. This report describes two cases of encephalomyelitis in patients with monkeypox disease that occurred during the current U.S. outbreak. Although neurologic complications of acute MPXV infections are rare, suspected cases should be reported to state, tribal, local, or territorial health departments to improve understanding of the range of clinical manifestations of and treatment options for MPXV infections during the current outbreak.
Management of relapsed/refractory Chronic Lymphocytic Leukemia
Authors: Jennifer A. Woyach
Journal: American Journal of Hematology (2022)

The therapeutic landscape for chronic lymphocytic leukemia (CLL) has changed dramatically over the past decade as our understanding of the biology of CLL has advanced, allowing the development of oral therapies targeting key drivers of CLL. Currently, inhibitors of Bruton's Tyrosine Kinase and the BH3 mimetic venetoclax are standards of care for both frontline and relapsed/refractory CLL. Sequencing of available therapies, therefore, has become a major challenge of therapy. In this review, we will focus on the current landscape for the treatment of relapsed/refractory CLL. We will also discuss important considerations when sequencing these available treatments. The recent advances in this disease are significant steps forward, and raise new questions of how these available drugs should be given as well as how we can continue to improve the treatment of CLL.
Herpes Zoster Incidence and Burden in Adults With Type 2 Diabetes in the U.S.: A Retrospective Database Analysis
Authors: Jean-Etienne Poirrier, Juliana L. Meyers, Saurabh P. Nagar, Brandon J. Patterson, Lisa I. Glasser, Serge A. Jabbour
Journal: Diabetes Care (2022)

OBJECTIVE Data on the real-world burden of herpes zoster (HZ) in adults with type 2 diabetes (T2D) in the U.S. are limited. We assessed HZ in patients with and without T2D and measured the impact of HZ on health care resource use (HCRU) and costs. RESEARCH DESIGN AND METHODS This retrospective cohort analysis used U.S. commercial claims data (sourced from claims incurred between 1 January 2012 and 31 July 2018). HZ incidence rates/1,000 person-years (PYs) were calculated in patients with and without T2D. HZ risk was evaluated using Poisson regression to generate adjusted incidence rate ratios (aIRRs). Patients with T2D with HZ were propensity score matched to patients with T2D only and to patients with HZ without T2D. HCRU and costs were compared across cohorts during a 1-year follow-up period. Cox proportional hazards analyses evaluated factors associated with HZ-related complications. RESULTS Crude HZ incidence rates in patients with and without T2D were 9.8/1,000 PY and 2.6/1,000 PY, respectively. T2D patients were almost twice as likely to be diagnosed with HZ (aIRR 1.84; 95% CI 1.82–1.85). HZ was associated with increased HCRU and health care costs. At 12 months, unadjusted incremental all-cause health care costs for patients with T2D with HZ versus patients with T2D without HZ were $5,216. The unadjusted incremental HZ-related health care costs for patients with T2D with HZ versus patients with HZ without T2D were $2,726. Age was the most important predictor for HZ-related complications. CONCLUSIONS Given the increased risk of HZ and HCRU and cost burden in patients with T2D, HZ prevention in patients with T2D may be beneficial.
Odds of Hospitalization for COVID-19 After 3 vs 2 Doses of mRNA COVID-19 Vaccine by Time Since Booster Dose
Authors: Jessica P. Ridgway, Samuel Tideman, Thomas French, Bill Wright, Guilford Parsons, George Diaz, Ari Robicsek
Journal: JAMA (2022)

This study assesses the association between COVID-19 mRNA booster immunization compared with vaccination with the primary mRNA vaccination series alone and odds of hospitalization for COVID-19.
Results of the North American Complex Abdominal Aortic Debranching (NACAAD) Registry
Authors: Guillermo A. Escobar, Gustavo S. Oderich, Mark A. Farber, Leonardo R. de Souza, William J. Quinones-Baldrich, Himanshu J. Patel, Jonathan L. Eliason, Gilbert R. Upchurch, Carlos H. Timaran, James H. Black, Sharif H. Ellozy, Edward Y. Woo, Mark F. Fillinger, Michael J. Singh, Jason T. Lee, Juan C. Jimenez, Purandath Lall, Peter Gloviczki, Manju Kalra, Audra A. Duncan, Sean P. Lyden, Emanuel R. Tenorio
Journal: Circulation (2022)

Hybrid debranching repair of pararenal and thoracoabdominal aortic aneurysms was initially designed as a better alternative to standard open repair, addressing the limitations of endovascular repair involving the visceral aorta. We reviewed the collective outcomes of hybrid debranching repairs using extra-anatomic, open surgical debranching of the renal-mesenteric arteries, followed by endovascular aortic stenting. Data from patients who underwent hybrid repair in 14 North American institutions during 10 years were retrospectively reviewed. Society of Vascular Surgery scores were used to assess comorbidity risk. Early and late outcomes, including mortality, morbidity, reintervention, and patency were analyzed. A total of 208 patients (118 male; mean age, 71±8 years old) were treated by hybrid repair with extraanatomic reconstruction of 657 renal and mesenteric arteries (mean 3.2 vessels/patient). Mean aneurysm diameter was 6.6±1.3 cm. Thoracoabdominal aortic aneurysms were identified in 163 (78%) patients and pararenal aneurysms in 45 (22%). A single-stage repair was performed in 92 (44%) patients. The iliac arteries were the most common source of inflow (n=132; 63%), and most (n=150; 72%) had 3 or more bypasses. There were 30 (14%) early deaths, ranging widely across sites (0%-21%). A Society of Vascular Surgery comorbidity score >15 was the primary predictor of early mortality (P<0.01), whereas mortality was 3% in a score ≤9. Early complications occurred in 140 (73%) patients and included respiratory complications in 45 patients (22%) and spinal cord ischemia in 22 (11%), of whom 10 (45%) fully recovered. At 5 years, survival was 61±5%, primary graft patency was 90±2%, and secondary patency was 93±2%. The most significant predictor of late mortality was renal insufficiency (P<0.0001). Mortality after hybrid repair and visceral debranching is highly variable by center, but strongly affected by preoperative comorbidities and the centers' experience with the technique. With excellent graft patency at 5 years, the outcomes of hybrid repair done at centers of excellence and in carefully selected patients may be comparable (or better) than traditional open or even totally endovascular approaches. However, in patients already considered as high-risk for surgery, it may not offer better outcomes.
Submucosal dissection of a large colonic angiodysplasia in case of failure of conventional treatment
Authors: Martin Bordet, Jérémie Jacques, Thomas Grainville, Mathieu Pioche, Mael Pagenault, Tanguy Brunet, Timothée Wallenhorst
Journal: Endoscopy (2022)

Digestive angiodysplasias are responsible for about 10 % of lower digestive bleeds and may also be revealed with an iron deficiency-related anemia [1]. They are common in elderly populations with a history of heart disease or anticoagulant medication. The currently recommended treatment is the use of argon plasma. However, this treatment can be associated with significant morbidity, especially for large angiodysplasias where post-procedural hemorrhage or secondary perforations are reported [2].
CARD8 makes coxsackievirus more “heartbreaking”
Authors: Qiankun Wang, Liang Shan
Journal: The Journal of Experimental Medicine (2022)

In this issue of JEM, Nadkarni et al. (2022. J. Exp. Med.https://doi.org/10.1084/jem.20212117) identify CARD8 as an innate sensor triggered by coxsackievirus B3 proteases to drive pyroptosis of aortic endothelial cells and cardiac myocytes, fueling viral replication and heart inflammation.
Yes &amp; No
Authors: Jillian Barnet
Journal: JAMA (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Oral Methylprednisolone and Decline in Kidney Function or Kidney Failure in Patients With IgA Nephropathy
Authors: Xianyun Ye, Yueming Liu
Journal: JAMA (2022)

To the Editor We have some comments about the recent TESTING trial1 that found that oral methylprednisolone significantly reduced the risk of the composite outcome of kidney function decline in patients with IgA nephropathy.
Optimal Pharmacologic Treatment of Heart Failure With Preserved and Mildly Reduced Ejection Fraction
Authors: Boyang Xiang, Ruiqi Zhang, Xiaoguang Wu, Xiang Zhou
Journal: JAMA Network Open (2022)

In recent years, significant progress has been made in the pharmacologic treatment of heart failure (HF) with reduced ejection fraction (HFrEF), but there is still insufficient evidence for drug therapy for HF with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF).To compare the outcomes associated with different drug combinations for the treatment of HFpEF and HFmrEF.A search of the PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted for studies published from inception to October 9, 2021.Randomized clinical trials on the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitors (ARNIs), mineralocorticoid receptor antagonists (MRAs), β-blockers, and sodium-glucose cotransporter 2 (SGLT2) inhibitors for patients with HFpEF or HFmrEF.Data extraction and bias assessment were independently performed by 2 reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. All data for 3 outcomes were pooled with a fixed-effect model.The main outcomes were first hospitalization for HF, all-cause mortality, and cardiovascular mortality. Hazard ratios (HRs) and 95% credible intervals (CrIs) were evaluated using a bayesian network meta-analysis model.In this analysis, 19 randomized clinical trials, including 20 633 patients with HF and an ejection fraction of 40% or more, without a remarkable risk of bias were included. Compared with placebo, no treatments were associated with a significant reduction in the risk of all-cause death or cardiovascular death. SGLT2 inhibitors, ARNIs, and MRAs were associated with a significant decrease in the risk of HF hospitalization compared with placebo (SGLT2 inhibitors: HR, 0.71 [95% CrI, 0.60-0.83]; ARNIs: HR, 0.76 [95% CrI, 0.61-0.95]; MRAs: HR, 0.83 [95% CrI, 0.69-0.99]), and SGLT2 inhibitors were the optimal drug class in terms of reducing the risk for HF admission. Sensitivity analysis results demonstrated a progressive decrease in the risk of HF admission and an advance in mean rank associated with the increasing use of drug classes.The findings of this study suggest that SGLT2 inhibitors were the optimal drug class for HFpEF and HFmrEF, consistent with the most recent guideline recommendation. The incremental use of combinations of SGLT2 inhibitors, ACE inhibitors or ARBs, and β-blockers may be associated with accumulative benefits in HF hospitalization rather than all-cause death among patients with HFpEF and HFmrEF.
Contralateral gallbladder perforation and hemoperitoneum caused by an electrocautery-enhanced lumen-apposing metal stent during endoscopic ultrasound-guided gallbladder drainage
Authors: Jiayi Su, Chuntao Liu, Peng Li, Jing Wu
Journal: Endoscopy (2022)

Endoscopic ultrasound (EUS)-guided gallbladder drainage (GBD) is an effective rescue therapy for biliary drainage after failed endoscopic retrograde cholangiopancreatography (ERCP) for unresectable malignant distal bile duct obstruction [1]. The use of the electrocautery-enhanced lumen-apposing metal stent (EC-LAMS) has been demonstrated to be safe and highly effective for EUS-GBD, and facilitates a single-step procedure [2].
Upregulating HIF‐1<i>α</i> to Boost the Survival of Neural Stem Cells via Functional Peptides‐Complexed MRI‐Visible Nanomedicine for Stroke Therapy
Authors: Zhe Wang, Yujun Cai, Qinyuan Zhang, Jianing Li, Bingling Lin, Junya Zhao, Fang Zhang, Yunhua Li, Xieqing Yang, Liejing Lu, Xintao Shuai, Jun Shen
Journal: Advanced Healthcare Materials (2022)

Neural stem cells (NSCs) transplantation has been considered as a promising strategy for the treatment of ischemic stroke. However, the therapeutic prospect is limited by the poor control over the survival, migration, and maturation of transplanted NSCs. Upregulating hypoxia inducible factor (HIF)-1α expression in stem cells can improve the survival and migration of NSCs grafted for stroke therapy. Functional peptide drugs, which could inhibit endogenous HIF-1α ubiquitination, might be used to effectively upregulate the HIF-1α expression in NSCs, thereby to improve the therapeutic effect in ischemia stroke. Herein, a magnetic resonance imaging (MRI)-visible nanomedicine is developed to codeliver functional peptides and superparamagnetic iron oxide (SPIO) nanoparticles into NSCs. This nanomedicine not only promotes the survival and migration ability of NSCs but also allows an in vivo tracking of transplanted NSCs with MRI. The results demonstrate the great potential of the functional peptides-complexed multifunctional nanomedicine in boosting the therapeutic effect of stem cell-based therapy in stroke.